Congestive Heart Failure: Overview, Symptoms, Causes and Treatment

Overview

Congestive heart failure, also known as heart failure, is a serious condition in which the heart muscle is unable to pump blood effectively. Due to this, the blood moves out of the heart at a slow speed, thereby increasing the heart pressure. As a result, the oxygen-rich blood that carries nutrients is unable to meet the body’s demands.

Due to the build-up of fluid in the lungs, you may experience shortness of breath. Also, as the chambers of the heart stretch to pump more blood, they get stiff and thick and eventually become weak. In response to all these, the kidney may start retaining fluid (water) and salt, which builds up in the legs, arms, feet, ankles and other organs of the body thereby causing congestion. Thus, the term congestive heart failure is used instead of heart failure.

This condition can be caused due to certain heart conditions such as high blood pressure, coronary artery disease etc. which makes the heart muscles weak and stiff. Proper treatment, lifestyle changes and managing stress can help you in living a longer life.

Heart failure can be life-threatening. To prevent this condition, it is important to monitor diabetes, high blood pressure, obesity and coronary artery disease.

The symptoms of heart failure are many and some people can show severe symptoms, ultimately needing a heart transplant.

In this article, we will discuss congestive heart failure symptoms, causes, prevention and treatment in detail.

Symptoms of Congestive Heart Failure 

Heart failure can be chronic i.e. ongoing or acute which is sudden and severe. Thus, depending upon the severity, congestive heart failure symptoms can be either constant or just come or go. The common signs and symptoms include:

• Fatigue, dizziness and weakness
• Shortness of breath
• Irregular or rapid heartbeat
• Lung congestion, wheezing or persistent cough
• Swollen legs, abdomen, ankles etc.
• Rapid weight gain and bloating
• Nausea or loss of appetite
• Difficulty in concentrating 
• Unable to exercise properly
• Chest pain in case of heart attack

You should seek emergency medical help if you experience chest pain, severe weakness, fainting and shortness of breath.

Causes of Congestive Heart Failure

Heart failure develops after the heart has become weak or damaged. But, it can also occur when the heart muscles become too stiff and the chambers are not able to fill properly between the beats. The ventricles get stretched and are unable to pump enough blood for the whole body, resulting in a shortage of fresh blood full of oxygen and nutrients.

The doctor can determine the condition of your heart by knowing its ejection fraction range. The ejection fraction measures how much blood is pumped out with every beat and thus helps the doctor to choose the right treatment. The ejection fraction is usually 50% or higher in the case of a healthy heart.

But it is important to understand heart failure caused due to other conditions like high blood pressure can show normal ejection fraction too.

Depending upon the side of the heart it affects, there are various types of heart failure such as left-sided heart failure, right-sided heart failure, systolic heart failure and heart failure with preserved ejection fraction.

The following conditions damage or weaken the heart muscles, thus causing heart failure:

• Coronary artery disease (CAD)
• Heart attack
• Cardiomyopathy
• Congenital heart defect
• Faulty heart valves
• High blood pressure
• Myocarditis – inflammation of the heart muscle
• Arrhythmias – abnormal heart rhythms
• Long-term diseases like HIV, diabetes, thyroid disorder and kidney disorder

Acute or sudden heart failure can be caused due to:

• Severe infections
• Blood clots in the lungs
• Using certain medications
• Allergic reactions
• Viruses
• Severe illness

Prevention of Congestive Heart Failure

The best way to prevent getting heart failure is to control or prevent the conditions that cause it. These are some of the ways that can help you:

• Quit smoking
• Making lifestyle changes such as eating healthy food
• Maintain a healthy weight
• Manage and reduce stress
• Stay physically active
• Control your high blood pressure 
• Monitor diabetes, if you are a known diabetic
• Properly follow your treatment in case of other heart conditions

Diagnosis of Congestive Heart Failure

The doctor will ask you for your complete medical history, review the symptoms and other risk factors such as high blood pressure, etc., and will then perform a physical exam along with other tests. Blood tests, chest X-rays, electrocardiogram (ECG), Echocardiogram, CT scan, MRI, stress test, myocardial biopsy and coronary angiogram are the tests that will help your doctor to correctly diagnose your condition.

Treatment For Congestive Heart Failure 

Being a chronic disease, congestive heart failure treatment requires lifelong management. But the medications help in reducing the severity of the disease by easing its symptoms and therefore improve the quality of life. Treating the underlying cause of heart failure with medications or surgery can make the heart stronger and could help in reversing the condition.

Medications

A combination of the following medicines is used, depending on the symptoms:

• Angiotensin-converting enzyme (ACE) inhibitors
• Beta-blockers
• Diuretics
• Angiotensin II receptor blockers
• Positive inotropes
• Aldosterone antagonists
• Vericiguat
• Digoxin (Lanoxin)
• Calcium channel blockers
• Heart pump medications
• SGLT2 (sodium/glucose cotransporter) inhibitor, etc.

Surgical Procedures

• Heart valve repair or replacement
• Coronary bypass surgery
• Ventricular assist devices (VADs)
• Implantable cardioverter-defibrillators (ICDs)
• Cardiac resynchronization therapy (CRT)
• Heart transplant

Moreover, doctors may also recommend palliative care i.e. specialized medical care for patients to improve their quality of life. In severe life-threatening cases, hospice care may be needed if medications are not working and a heart transplant or device cannot be used.
To avoid congestive heart failure, it is important to stay away from the factors causing this condition and to take your prescribed medicines regularly. Follow a healthy lifestyle to improve your quality of life and prevent heart failure.